頁籤選單縮合
題 名 | 末期病人死亡前48小時慢性病藥物使用之病歷回溯=Chronic Disease Medications Used in Last 48 Hours of Life: A Medical Record Review |
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作 者 | 顏正中; 許瀞分; 陳正裕; | 書刊名 | 安寧療護 |
卷 期 | 18:2 2013.07[民102.07] |
頁 次 | 頁155-162 |
分類號 | 419.77 |
關鍵詞 | 末期病人; 慢性病藥物; Terminal patients; Chronic disease medications; |
語 文 | 中文(Chinese) |
中文摘要 | 安寧病房的病人以癌症末期為主,有許多人同時有其他慢性疾病的共病情形持續在服用藥物控制中。本文想探討病人死亡前48小時還持續使用慢性病藥物的比率與使用是否適當。統計方式為查閱民國98年10月至民國100年9月本院安寧病房住院病人之病歷。統計其基本資料以及住院中用藥,發現有39位病人(占10.3%)在死亡前48小時仍有開立慢性病藥物,不過隨著病人病情變化也逐漸停藥。但一直到死亡前也未停藥的仍有16人(占41%)。從使用藥物類別來看,還是以降血壓藥物為大宗,占所有用藥一半以上的比例(53.1%)。藉由這次病歷回溯,發現在安寧照護上,醫護團隊對於末期病人使用慢性病藥物的原則以及停藥的時機點,應該要更積極的介入與調整,更要隨時與團隊、病人及家屬討論。目的是讓病人有更好的生活品質,以期達成病家身心靈皆平安的目標。 |
英文摘要 | Many terminally ill patients have comorbid chronic diseases under medical control, including diabetes mellitus, hypertension, cardiac diseases, etc. Medications for these chronic diseases often need to be adjusted in the terminal stage of life.Medical records of all patients admitted at the hospice ward in Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation from October 2009 to September 2011 were reviewed for demographics and rationale of chronic disease medications used during the patients' last 48 hours of life.Of the 380 patients, 39 (10.3%) were on medications for chronic diseases during their last 48 hours of life. Among the 39 patients, anti-hypertensive agents (53.1%) were most frequently used compared to medications for other cardiac diseases (18.4%), anti-depressants (12.2%), and oral hypoglycemic agents (8.2%).Prescribing chronic disease medications to terminally ill patients, especially those in the dying phase, needs further justification in the palliative practice. To improve the quality of care and save medical resources, clear discussion about the use of chronic disease medications with the patients and families is necessary in the early stage of hospice care. |
本系統中英文摘要資訊取自各篇刊載內容。